The challenge of sustainability in healthcare systems: Frequency and cost of inappropriate patterns of breast cancer care (the E.Pic.A study)

Abstract

If systematically applied, this method could help provide a complete picture of inappropriateness and waste, redirect these resources to higher-value interventions for patients, and fill the gap between proper use of the resources and the best clinical results.

Assessment of Cancer Care Costs in Disease-Specific Cancer Care Pathways

“…The care pathways are defined as general clinical plans aiming at mapping the patient transition through different levels of the local healthcare system [ 25 , 26 ] and at optimizing the use of the Italian National Health Service (INHS)—funded healthcare resources. The workgroups are provided with detailed information on key performance indexes and main cost components, as previously described [ 16 ].…”

“…The standard strategy for improving cancer care while controlling the costs [ 10 , 11 , 12 , 13 ] is to promote the adherence to clinical practice guidelines [ 14 ]. A new, and promising, solution is to perform qualitative analyses of medical procedures in order to improve the uptake of research findings into practice [ 15 ] and to identify areas of low-value use of resources [ 16 ]. A related useful approach is to obtain population-based data on cancer-related health services and their costs in epidemiologically comparable geographic areas, which would enable to identify unwarranted variations caused by non-standard practices.…”

“…The results of a first empirical study, specifically addressing the objective (b), have shown that there is potential room for redistributing resources inappropriately used [ 16 ]. This second article focuses on the objective (c).…”

Key performance indicators for monitoring the integrated care pathway in breast cancer: the E.Pic.A. project

“…Specifically, the methodology attempts to identify potential areas with low "value" in terms of utilisation of resources, and reducing the associated costs. An initial and partial application of this methodology has recently been carried out at the Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST of Meldola (Forlì, Italy) (17). The study estimated that the hospital provided 2,516 inappropriate examinations (from January 2010 to June 2016) with a total cost of about €580,000.…”

The challenge of sustainability in healthcare systems: frequency and cost of diagnostic procedures in end-of-life cancer patients

“…In particular, the expenditure for cancer care in the USA was estimated in 2006 to rise from $104 to over $173 billion by 2020 [ 9 , 10 ]. In Italy, as oncology care running costs are at risk of undermining healthcare sustainability, it is crucial to limit inappropriate interventions throughout the entire care pathway [ 11 ].…”